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Economic Model Estimates Total Costs of Tisagenlecleucel Treatment for ALL

September 11, 2020

An economic model estimated the total costs associated with tisagenlecleucel treatment for pediatric and young adult patients with relapsed/refractory acute lymphoblastic leukemia (ALL) to be $612,779 (J Manag Care Spec Pharm. 2020;26[8]:971-980. doi:10.18553/jmcp.2020.20052).

“Tisagenlecleucel was approved for the treatment of pediatric and young adult patients with relapsed/refractory… [ALL] based on the pivotal ELIANA trial,” wrote Hongbo Yang , PhD, Analysis Group, Boston, Massachusetts, and colleagues.

In order to estimate the total costs associated with tisagenlecleucel treatment from a US hospital’s perspective, Dr Yang and colleagues developed an economic model. The economic model evaluated costs from the time of leukapheresis to 2 months postinfusion.

Costs were estimated based on resource use and safety management from the ELIANA trial. Cost components included leukapheresis, lymphodepleting chemotherapy, tisagenlecleucel infusion and hospital administration, inpatient and intensive care unit admissions, medical professional visits, laboratory tests and procedures, and management of major adverse events.

The model estimated the total cost associated with tisagenlecleucel treatment to be $612,779. Additional costs on top of the list price ($475,000) and administration cost (4143.08) equate to $137,636, 22.5% of the total cost.

The top 3 drivers of additional cost were adverse event management ($70,968; 51.6%), inpatient and intensive care unit admissions not attributed to adverse events ($57,952; 42.1%), and laboratory tests and procedures ($5,209; 3.8%).

The estimated costs accrued during pretreatment were $29,002, during infusion were $476,659, and during follow-up were $107,188.

The scenario analysis found the totals costs ranged from $483,169 for tisagenlecleucel treatment in the outpatient setting, without adverse events, to $672,373 for tisagenlecleucel treatment in the inpatient setting with grade 3/4 cytokine release syndrome and B-cell aplasia.

“In this economic model, tisagenlecleucel treatment among pediatric and young adult patients with r/r ALL was estimated to cost $612,779. The cost of care in addition to the price of tisagenlecleucel accounted for 22.5% of the total, with adverse event management and inpatient and intensive care unit admissions being main drivers,” Dr Yang and colleagues concluded.

“Further studies are warranted to assess the cost of tisagenlecleucel treatment in the context of current standards of care in real-world clinical practice,” they added.—Janelle Bradley

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